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Periodontal disease associated with increased oral cancer odds in meta-analysis of case-control studies

Periodontal disease associated with increased oral cancer odds in meta-analysis of case-control stud…
Photo by Ozkan Guner / Unsplash
Key Takeaway
Consider periodontal disease as associated with increased oral cancer odds, but recognize this is observational correlation.

This systematic review and meta-analysis examined the association between periodontal disease and oral cancer across 18 case-control studies from 13 regions, involving 31,504 human subjects aged over 18. The analysis compared individuals with periodontal disease to those without, with the primary outcome being odds of developing oral and/or head and neck cancers.

The main analysis found periodontal disease was associated with significantly increased odds of oral cancer (odds ratio 3.35, 95% CI 2.63-4.26; P < .001). After adjustment for potential confounders, the association remained significant though attenuated (adjusted odds ratio 2.32, 95% CI 1.71-3.15; P < .001). Effect sizes varied depending on the periodontal disease case definition used, ranging from OR 2.02 when defined by missing teeth to OR 2.68 when using American Academy of Periodontology clinical parameters.

Safety and tolerability data were not reported in the included studies. Key limitations include the observational case-control design, which cannot establish causation, and potential residual confounding despite adjustment. The authors suggest these findings warrant interdisciplinary attention, but clinicians should interpret the association cautiously given the inherent limitations of case-control evidence.

Study Details

Study typeMeta analysis
Sample sizen = 31,504
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
OBJECTIVE: Since emerging studies have reported a positive association on oral cancer and periodontal disease, the present study aimed to evaluate the odds ratio of having concurrent oral cancer in patients with periodontal disease. METHOD AND MATERIALS: A systematic review following the PRISMA guidelines was conducted with three electronic databases. The inclusion criteria were structured according to the PECOS framework: (P) Human subjects aged over 18; (E) Patients with periodontal disease; (C) Individuals without periodontal disease; (O) The odds of patients developing oral and/or head and neck cancers; (S) Case-control studies. After screening, 18 clinical studies from 13 different regions, comprising a total of 31,504 participants, were included. RESULTS: A meta-analysis was performed and revealed that the odds ratio for developing oral cancer in patients with periodontal disease, compared to those without, was 3.35 (95% CI 2.63-4.26; P .001). After adjusting for potential confounding factors, the adjusted odds ratio was found to be 2.32 (95% CI 1.71-3.15; P .001). Case definition also has an impact, with odds ratio of 2.02 if using missing teeth compared to odds ratio of 2.68 by using American Academy of Periodontology clinical periodontal parameters. CONCLUSION: Clinical considerations for this specific group of patients should draw new attention for a strategic interdisciplinary care.
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